Humana Issues New Brief on Value-Based Care for Kidney Disease

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What You Should Know: 

– Health insurance provider Humana Inc. announced the release of a groundbreaking Value-Based Care (VBC) Issue Brief focused on nephrology, the medical specialty treating kidney disease. 

– The issue brief report highlights the significant potential of VBC arrangements to improve patient outcomes and reduce healthcare costs for individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD).

VBC: A Shift from Quantity to Quality

VBC represents a paradigm shift in healthcare, moving away from fee-for-service models that reward the number of patients seen and procedures performed. Instead, VBC incentivizes healthcare providers based on patient outcomes and the quality of care delivered. This focus on results aligns well with the needs of CKD and ESRD patients, who require ongoing management and preventive measures.

The Growing Challenge of Kidney Disease

Chronic kidney disease affects an estimated 37 million adults in the United States, often linked to conditions like diabetes and high blood pressure. Left untreated, CKD can progress to ESRD, requiring dialysis or a kidney transplant. According to theUSRDS 2021 Annual Data Report, the number of newly diagnosed ESRD patients has risen by 40% in a single year. Tragically, the Health Research Funding Organization reports that 15 people die each day while awaiting a kidney transplant.

VBC: Transforming Kidney Care

Humana’s Issue Brief outlines the numerous benefits that VBC offers to kidney patients. Patients enrolled in VBC programs experience:

  • Smoother care coordination: Improved collaboration between primary care physicians (PCPs) and specialists.
  • Reduced hospital admissions: Fewer unnecessary hospitalizations due to proactive management.
  • Cost savings: More efficient use of healthcare resources translates to lower overall costs.
  • Improved health outcomes: Early intervention and preventive care enhance long-term health.
  • Proactive management of dialysis and transplant options: VBC incentivizes clinicians to prepare patients for these life-changing decisions.

Data Demonstrates VBC’s Effectiveness

Humana’s data reveals a compelling case for VBC in nephrology. Compared to fee-for-service patients, Humana Medicare Advantage enrollees in VBC nephrology programs experienced a 5% reduction in unnecessary hospital admissions in 2023. Additionally, Humana members in VBC nephrology practices report improved patient engagement and more sustainable management of kidney disease costs.

Humana’s VBC in Nephrology Issue Brief underscores their commitment to revolutionizing kidney care through value-based arrangements. This report showcases the transformative impact of VBC models on specialty medical practices and population health outcomes.

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